Atomizer for dispensing liquids for medical purposes

ABSTRACT

Atomizers ( 1 ) comprising a cartridge holder ( 4 ) which is arranged in the housing ( 3 ), a mouthpiece ( 5 ) which is provided on the housing ( 3 ) and in which an atomization device ( 6 ) is arranged, and a connecting tube system ( 7 ) which connects the atomization device ( 6 ) and the cartridge holder ( 4 ), wherein the atomization device ( 6 ) has at least one nozzle body ( 8 ) and the connecting tube system ( 7 ) has at least one passage ( 9 ) with a hollow plunger ( 10 ) mounted displaceably therein, wherein the hollow plunger ( 10 ) includes a valve body ( 21 ). In accordance with a first embodiment the atomizer ( 1 ) has a first hollow plunger ( 10   a ) mounted displaceably in a first passage ( 9   a ) and a second hollow plunger ( 10   b ) mounted displaceably in a second passage ( 9   b ), wherein the first hollow plunger ( 10   a ) and the second hollow plunger ( 10   b ) extend into the cartridge holder ( 4 ).

BACKGROUND OF THE INVENTION

1. Field of the Invention

The invention concerns an atomizer for dispensing liquids for medicalpurposes, for example pharmaceutical active substance formulations, fromat least one container for the liquid, which can be fitted into theatomizer (cartridge), as well as a cartridge and a system comprising anatomizer and a cartridge which can be fitted therein.

2. Description of the Prior Art

The known atomizers include as essential units a cartridge holder whichis arranged in the housing, a mouthpiece which is provided on thehousing and in which an atomization device is arranged, and a connectingtube system which connects the atomization device and the cartridgeholder, wherein the atomization device has at least one nozzle body andthe connecting tube system has at least one passage with a hollowplunger mounted displaceably therein, wherein the hollow plungerincludes a valve body.

The hollow plungers which are inserted in the atomizers include a valvebody. Upon a downward movement of the hollow plunger, in an openposition, the valve body permits an intake flow of the formulation orformulations which are already mixed, into the portion of the passagewhich is downstream of the hollow plunger in the flow direction. Upon anupward movement of the hollow plunger the valve body closes the hollowplunger and, upon further upward movement, the formulation or themixture disposed downstream of the hollow plunger in the flow directionis compressed to the desired pressure.

Atomizers of that kind are used for the application of liquid drugformulations which are effective by inhalation, in which case the liquidformulations must satisfy high quality standards. In order to achieve agood distribution of the active substances in the lung, application of aliquid formulation which does not involve the use of propellant gases,by means of inhalers or atomizers which are suitable for that purpose,presents itself as an option. Particularly suitable atomizers are thosewhich can nebulize a small amount of a liquid formulation in thetherapeutically necessary dosage into a therapeutically-inhalativelysuitable aerosol, within a few seconds. In that respect the nebulizationduration should be optimized in respect of time in order to guaranteeoptimum lung deposition. In accordance with the present invention, thosenebulizers are preferred, in which an amount of less than 100microliters, preferably less than 50 microliters, quite preferably lessthan 20 microliters of active substance solution are already atomizedwith one stroke or a few strokes to afford an aerosol with an averageparticle size of less than 20 micrometers, preferably less than 10micrometers.

Such a device for propellant gas-free administration of a dosed amountof a liquid drug for inhalation use is described in detail for examplein international patent application WO 91/14468 ‘Atomizing Device andMethods’ and also in WO 97/12687. In such an atomizer a drug solution isconverted by means of high pressure of up to 500 bars into alung-treating aerosol.

In the known atomizers the active substance formulations are stored inthe form of solutions in a reservoir. In that case it is necessary forthose solutions used to enjoy adequate storage stability and at the sametime to be such that they can be applied directly in accordance with themedical purpose as far as possible without further manipulation. Inaddition, they should not have any constituents that can interact withthe atomizer, so that neither the atomizer, nor the solution, nor theaerosol produced, suffer damage.

Nebulization of the solution is effected by using a special nozzle as isdescribed for example in WO 94/07607 or WO 99/16530.

A further development in the construction of the preferred inhaler isalso disclosed in WO 97/12687.

By virtue of its cylinder-like shape and its easily manageable size ofless than 9 to 15 cm in length and 2 to 4 cm in width the knownatomizers can be carried around by the patient at any time. The atomizersprays a defined volume of the drug formulation using high pressuresthrough small nozzles so that inhalable aerosols are produced.

EP 0 918 570 describes an atomizer for nasal sprays which as corecomponents includes a spring-operated plunger and a nozzle device. It ispossible to insert between the plunger and the nozzle a container whichat its bottom has a ram and at its head side is closed by way of a seal.That seal of the container is opened prior to the first use by movingthe external nozzle which is integrated in the atomizer through theseal.

The described atomizers, however, are primarily suited for the deliveryof stable solution formulations, that is to say, for formulationconstituents that can be stably mixed with each other and that can bestored over a prolonged period of time. Thus it is a prerequisite forexample in the case of combination preparations which contain at leasttwo active substances that the active substances to be administered arefor example stable at the same pH-value in the same solvent.

In addition various principles of devices for administering medicamentsare known from the state of the art, which are stored separately priorto their administration but which are then available to the patient as amixture.

WO2004/011068 discloses an electronic system for the administration ofmedicament mixtures.

WO2004/011071 discloses a system for administering medicaments, whereinthe two medicament containers are of different kinds.

WO2004/011067 and 011070 also disclose systems for administeringmedicament mixtures, wherein 01170 claims the administration of aplurality of co-formulated medicaments with a medicament which is notsuitable for co-formulation.

WO2004/011067 claims a simple system for administering medicaments whichare stored in separate containers but which can be administered to thepatient in the form of a mixture.

SUMMARY OF THE INVENTION

The object of the present invention is now that of providing an atomizerwhich also makes it possible to store, mix, and administer formulations,in a flow direction, which can be stably stored only under comparativelydifferent conditions such as for example pH-value, solvent, oradditives.

The invention further seeks to provide a cartridge for the storage ofthe formulations.

A further sub-object of the invention lies in the provision of a systemcomprising an atomizer and a cartridge.

According to the invention, that object is first attained with anatomizer in which a first hollow plunger is mounted displaceably in afirst passage and a second hollow plunger is mounted displaceably in asecond passage, wherein the first hollow plunger and the second hollowplunger extend into the cartridge holder. The term hollow plunger isused to denote a tubular plunger whose outside diameter is of onlyslightly smaller dimension than the inside diameter of the passage. Thefirst and second passages are preferably bores of a round shape incross-section and which extend in substantially mutually parallelrelationship. In that case the passages perform two tasks. On the onehand they serve as a guide for the hollow plunger mounted therein, inthe axial direction of movement, while on the other hand the formulationof the active substance is passed through therein on the way to thenozzle body. The portion of the passage from the nozzle body to the endof the hollow plunger, which is downstream in the flow direction, at thesame time represents a pressure chamber whose volume progressivelydecreases upon an upward movement of the hollow plunger. The front endof the hollow plunger, which is in the flow-direction, projects into thecartridge holder.

Advantageously, the atomization device includes a first nozzle body withat least one first nozzle outlet and a second nozzle body with at leastone second nozzle outlet, wherein the first nozzle body is connected tothe first passage and the second nozzle body is connected to the secondpassage. In this embodiment two different liquids are passed completelyseparately from each other through the atomizer and are only combined toform an aerosol cloud outside the device. As a result of this contactsbetween different formulations and reactions resulting therefrom duringstorage and atomization are minimized.

The first nozzle outlet of the first nozzle body and the second nozzleoutlet of the second nozzle body can be inclined relative to each otherso that the two liquids meet and experience mutual atomization outsidethe atomizer.

It has proven to be particularly desirable if the first nozzle body hastwo nozzle outlets and the second nozzle body has two nozzle outlets,wherein the two nozzle outlets of a nozzle body are preferably inclinedrelative to each other. In that case two liquids are atomized inparallel relationship in respect of time, so that two aerosol clouds areproduced which mutually interpenetrate. In principle, instead of twoseparate nozzle outlets per nozzle head, still further nozzle outletsare possible.

In accordance with another embodiment the atomization device has onlyone nozzle body, wherein the first and second passages are guided intothe nozzle body and are each provided with a first and a second nozzleoutlet. In that case a common aerosol cloud is formed from the twoissuing liquid jets after issue thereof from separate nozzle outlets. Inthis embodiment also the first nozzle outlet and the second nozzleoutlet of the common nozzle body are inclined relative to each other sothat the two liquid jets meet in front of the nozzle body, therebyproviding for mutual atomization.

In addition, a plurality of separate nozzle bodies which each have twoor more nozzle outlets make it possible for different particle sizes tobe simultaneously produced from the different formulations. Thus forexample a larger particle size of a first formulation can beadministered for treatment of the upper airways and at the same time asmaller lung-reaching particle size of the second formulation can beadministered for treatment of the lower airways.

In a further advantageous embodiment the atomization device includes anozzle body, in front of which in the flow direction is arranged amixing passage in which the first and second passages are broughttogether. That mixing passage feeds the solution which has already beenmixed to the nozzle body. Preferably in this embodiment also there aretwo nozzle outlets which are inclined relative to each other and withwhich an aerosol cloud is produced.

As an alternative to the above-described embodiment the atomizationdevice can also have a nozzle body with a plenum chamber which isarranged therein and in which the first and second passages are broughttogether. In this embodiment the mixing passage has been moved into thenozzle body and is referred to as a plenum chamber in order todistinguish it from the foregoing embodiment. Production of the aerosolcloud is implemented in a manner corresponding to the above-describedembodiments.

The object of the invention is also attained with an atomizer in whichat least one of the hollow plungers is branched at its end near thecartridge holder into a first and a second plunger portion, wherein thefirst and the second plunger portions extend into the cartridge holder.In that configuration a hollow plunger is mounted displaceably in apassage. Outside the passage the hollow plunger branches into twoplunger portions. As a departure from the above-described embodiments,preparation of the mixture consisting of two formulations does not takeplace in the mixing or plenum chamber but already occurs in the hollowplunger. For producing the aerosol cloud, this atomizer can also have inthe single nozzle body a first and a second nozzle outlet which arepreferably respectively inclined relative to each other.

In all embodiments, in the case of a plurality of nozzle outlets, theinclined nozzle outlets are oriented in such a way that they produce jetdirections of the liquids at an impingement angle of preferably 20° to160°, particularly preferably 60° to 150° and quite particularlypreferably 80° to 100°. The impingement angle crucially determines theimpaction spacing, that is to say the spacing from the nozzle outlets atwhich the two liquids meet. That impaction spacing may not be selectedto be too large as otherwise adequate atomization does not take place.

Preferably the nozzle outlets on a nozzle body are arranged at adistance of 10 μm to 200 μm, preferably from 10 μm to 100 μm,particularly preferably 30 μm to 70 μm, most preferably at 50 μm.

Preferably the valve body is arranged at the end of the hollow plunger,which is the downstream end in the flow direction. That prevents aback-flow of the formulation or the mixed formulations into the hollowplunger.

Desirably the at least one nozzle body is fixed stationarily to the atleast one passage.

Preferably the cartridge holder is mounted movably.

A stressing element can be arranged in the housing to store apredetermined amount of energy. The stressing element used can be forexample a coil spring which can be stressed in its axial direction. Uponactuation of a release button the prestressed stressing element providesthe amount of energy and displaces the cartridge holder in the axialdirection of the housing, that is to say, in the direction of theatomization device. The properties of the stressing element determinethe amount of energy which can be applied to the formulations and thussubstantially the attainable fluid pressure of the formulations. Thefluid pressure involved is 100 bars to 700 bars, preferably 200 bars to500 bars.

The first sub-object of the invention is attained by a cartridge whichhas a first and a second cartridge chamber wherein a first liquid isstored in a first cartridge chamber and a second liquid is stored in asecond cartridge chamber which is spatially separated from the firstcartridge chamber. In this case the two liquids are disposed in onecartridge, whereby manageability when inserting the cartridge issimplified.

Preferably the cartridge has a peripheral, cover, and bottom wall whichis stable in respect of shape.

The further sub-object is attained by a system in which a first liquidis stored in a first cartridge or cartridge chamber and a second liquidis stored in a second cartridge or cartridge chamber which is spatiallyseparated from the first cartridge or cartridge chamber, and a firsthollow plunger can be inserted into the first cartridge or cartridgechamber and a second hollow plunger can be inserted into the secondcartridge or a first plunger portion connected to the hollow plunger canbe inserted into the first cartridge or first cartridge chamber and asecond plunger portion can be inserted into the second cartridge orsecond cartridge chamber.

BRIEF DESCRIPTION OF THE DRAWINGS

For better understanding the invention is described in greater detailhereinafter with reference to the Figures in which:

FIG. 1 shows a view in longitudinal section through the atomizer withtwo nozzle bodies and two passages extending in parallel relationshipwith hollow plungers guided therein in accordance with a firstembodiment with two cartridge chambers in a cartridge,

FIG. 2 is a view corresponding to FIG. 1 with a nozzle body and twopassages extending in parallel relationship with hollow plungers guidedtherein in accordance with a second embodiment,

FIG. 3 is a view corresponding to FIG. 1 with a nozzle body and a mixingpassage in which the first and second passages are brought together inaccordance with a third embodiment,

FIG. 4 is a partial view corresponding to FIG. 1 with a nozzle body anda plenum chamber arranged therein, in which the first and secondpassages are brought together in accordance with a fourth embodiment,

FIG. 5 is a view corresponding to FIG. 1 with a nozzle body and a hollowplunger branched into plunger portions, in accordance with a fifthembodiment, and

FIG. 6 is a view in longitudinal section through a cartridge with afirst and a second cartridge chamber.

DESCRIPTION OF THE INVENTION

Hereinafter identical parts are denoted by the same references.

FIG. 1 shows a view in longitudinal section through the atomizer 1having a first nozzle body 8 a and a second nozzle body 8 b and twopassages 9 a, 9 b extending in parallel relationship, with hollowplungers 10 a, 10 b guided therein, in accordance with a firstembodiment. The passages 9 a, 9 b and the hollow plungers 10 a, 10 btogether form the connecting tube system 7.

The atomizer includes a housing which is divided into two and which isrotatable relative to each other and by way of which a stressing element23 can be stressed. Upon actuation of a release button 24 a cup-shapedthrust plate 27 is released and advanced by the spring force of thestressing element 23 in the flow direction 15 (see FIG. 2). In that casethe two hollow plungers 10 a, 10 b which are fixed to the thrust plate27 and passed therethrough are also advanced, together with the thrustplate 27, and in so doing compress the liquids which were previouslysucked into the passages 9 a, 9 b and which then issue from the firstnozzle body 8 a and the second nozzle body 8 b. The formation of twoseparate aerosol clouds is effected by way of respective nozzle outlets11 a 1, 11 a 2, 11 b 1, 11 b 2 arranged in the nozzle bodies 8 a, 8 b,that is to say a total of four nozzle outlets.

For renewed use the stressing element 23 is tensioned again, whereby thethrust plate 27 and the hollow plungers 10 a, 10 b are displaced with adownward movement. Due to the downward movement of the hollow plungers10 a, 10 b, the respective formulation is sucked out of the cartridgechambers 2 a, 2 b into the respective first passage 9 a or the secondpassage 9 b. In that downward movement the two valve bodies 21 a, 21 bare in a flow-transmitting position.

Upon actuation of the release button 24 the hollow plungers 10 a, 10 bare displaced in the axial direction 25 of the housing 3, that is to saythey are displaced with an upward movement. In that case the respectivevalve body 21 a, 21 b automatically closes off the first hollow plunger10 a or the second hollow plunger 10 b and thereby permits the liquid tobe compressed. The valve bodies 21 a, 21 b are disposed at the rear ends22 (see FIG. 2) of the respective hollow plunger 10 a, 10 b.

During the upward movement of the first hollow plunger 10 a and thesecond hollow plunger 10 b the patient fits his mouth around themouthpiece 5 provided on the housing 3 and can inhale the aerosol. Themouthpiece 5 can be covered with a closure cover 26.

In the embodiment shown in FIG. 1 the passages 9 a, 9 b are eachprovided with their own respective nozzle bodies 8 a, 8 b. For thepassage of the respective liquid the nozzle bodies 8 a, 8 b have twonozzle outlets 11 a 1, 11 a 2 on the first nozzle body 8 a and twofurther nozzle outlets 11 b 1, 11 b 2 on the second nozzle body 8 b. Thenozzle outlets 11 b 1, 11 b 2 of the second nozzle body 8 b are orientedin such a way that the liquid jets which issue from the nozzle outlets11 b 1, 11 b 2 in the jet direction 12 meet at the impaction spacing 14.The same applies for the liquid issuing from the first nozzle body 8 afrom the nozzle outlets 11 a 1, 11 a 2. In that way two separate aerosolclouds are produced, which mix with each other.

The nozzle outlets 11 a 1, 11 a 2 of the first nozzle body 8 a, like thenozzle outlets 11 b 1, 11 b 2 of the second nozzle body 8 b, arerespectively spaced with respect to each other at the distance 14 a.

FIG. 2 shows a second embodiment of the atomizer in which the passages 9a, 9 b, in the region of the atomization device 6, extend in a commonnozzle body 8 and issue there by way of a separate individual firstnozzle outlet 11 a and a second individual nozzle outlet 11 b.

As can be seen from FIG. 2 the respective liquids issue at a jetdirection 12 and meet in front of the atomizer 1. In that situation theliquids come together at the impingement angle 13. Due to theformulations meeting, particularly fine nebulization and mixing of theformulations is achieved, with an aerosol cloud being produced from thetwo liquids in this embodiment.

FIG. 3 shows a third embodiment of the invention in which the passage 9is in the form of a mixing passage 16, that is to say the first passage9 a and the second passage 9 b combine in the mixing passage 16. Hollowplungers 10 a, 10 b are mounted displaceably in respective ones of thepassages 9 a and 9 b.

In the embodiment of FIG. 3 mixing of the two liquids already takesplace in the suction process, that is to say, upon a downward movementof the two hollow plungers 10 a, 10 b.

Upon an upward movement of the two hollow plungers 10 a, 10 b theformulation which has been previously respectively sucked in and whichis to be found in the passage 9 a, 9 b is compressed and expelled in thedirection of the nozzle body 8. A nozzle outlet 11 a is visible in theview shown in FIG. 3. Mixing of the formulation which is sucked in byway of the hollow plunger 10 a from the first cartridge chamber 2 a andthat which is sucked in by way of the hollow plunger 10 b from thesecond cartridge chamber 2 b is therefore effected in the mixing passage16 in this embodiment. The valves 21 prevent a back-flow from the mixingpassage 16 back into the cartridge chamber.

FIG. 4 shows a fourth embodiment of the invention which has a plenumchamber 17 disposed in the nozzle body 8, instead of the mixing passage16 which can be seen from FIG. 3. The passages 9 a, 9 b terminate inthat plenum chamber 17 so that there the formulations are mixed togetherupon an upward movement of the hollow plungers. As a departure from theembodiment of FIG. 3 mixing does not take place when the liquids aresucked in but when they are discharged.

FIG. 5 shows a further fifth alternative embodiment in which a hollowplunger 10 is mounted displaceably in a passage 9. The single passage 9terminates in the flow direction 15 in the nozzle body 8 through whichthe solution mixture can issue by way of the nozzle outlets 11 a, 11 b.Only the first nozzle outlet 11 a is visible in the FIG. 5 view. Outsidethe plunger 9, in the region of the end 18 of the hollow plunger 10,which is near the cartridge holder, the hollow plunger 10 branches intoa first plunger portion 19 and a second plunger portion 20. In this caseboth plunger portions 19, 20 extend into the cartridge holder 4.

As a departure from the above-illustrated embodiments, two physicallyseparate cartridges are disposed in the cartridge holder 4, namely afirst cartridge 55 and a second cartridge 56. This embodiment is lesspreferred.

FIG. 6 shows a cartridge 2 according to the invention having acylindrical cartridge chamber 2 a and a cartridge chamber 2 b which isdisposed therebeside and which is also cylindrical.

The two cartridge chambers 2 a, 2 b have their own internal walls 57, 58which are arranged in spaced relationship with the peripheral wall 50and the bottom wall 52. The cover wall 51 is pierced by insertion aids59 into which the hollow plungers 10 a, 10 b can engage and, after theclosure diaphragm 51 a is pierced, can be inserted into the firstcartridge chamber 2 a and the second cartridge chamber 2 b.

LIST OF REFERENCES

-   1 atomizer-   2 cartridge-   2 a first cartridge chamber-   2 b second cartridge chamber-   3 housing-   4 cartridge holder-   5 mouthpiece-   6 atomization device-   7 connecting tube system-   8 nozzle body-   8 a first nozzle body-   8 b second nozzle body-   9 passage-   9 a first passage-   9 b second passage-   10 hollow plunger-   10 a a first hollow plunger-   10 b second hollow plunger-   11 a first nozzle outlet nozzle body-   11 b second nozzle outlet nozzle body-   11 a 1 first nozzle outlet first nozzle body-   11 a 2 second nozzle outlet first nozzle body-   11 b 1 first nozzle outlet second nozzle body-   11 b 2 second nozzle outlet second nozzle body-   12 jet direction-   13 impingement angle-   14 impaction spacing-   14 a distance nozzle outlets of a nozzle body-   15 flow direction-   16 mixing passage-   17 plenum chamber-   18 end of the hollow plunger (10) near the cartridge holder-   19 first plunger portion-   20 second plunger portion-   21 a first valve body-   21 b second valve body-   22 rear end of hollow plunger-   23 stressing element-   24 release button-   25 axial direction of the housing (3)-   26 closure cover-   27 thrust plate-   50 peripheral wall cartridge-   51 cover wall cartridge-   51 a closure diaphragm-   52 bottom wall cartridge-   55 first cartridge-   56 second cartridge-   57 internal wall first cartridge-   58 internal wall second cartridge-   59 insertion aids

1. An atomizer for mixing and dispensing a liquid for medical purposes,comprising: a cartridge holder, operable to receive at least onecartridge therein, which is arranged in the housing, a mouthpiece whichis provided on the housing and includes an atomization device, which isoperable to dispense the liquid in a flow direction, and a connectingtube system which connects the atomization device and the cartridgeholder, wherein the atomization device has a plurality of nozzle bodies,each of the nozzle bodies having at least two nozzle outlets that aresized and shaped such that each nozzle body produces one or moreparticles that are different in size from the other one or moreparticles of the other nozzle bodies, the connecting tube system has atleast one passage with a hollow plunger mounted displaceably therein,and the hollow plunger includes a first hollow plunger mounteddisplaceably in a first passage and a second hollow plunger mounteddisplaceably in a second passage, wherein the first hollow plunger andthe second hollow plunger extend from the at least one cartridge in theflow direction, a first liquid flows from the at least one cartridgethrough the first hollow plunger in the flow direction, a second liquidflows from the at least one cartridge through the second hollow plungerin the flow direction, and the nozzle outlets of each of the nozzlebodies are spaced and inclined such that the first liquid emerging fromthe nozzle outlets of the first nozzle body mixes with the second liquidfrom adjacent nozzle outlets of the second nozzle body in the flowdirection to produce the liquid, in a manner that the liquid is atomizedto include the one or more differently sized particles by the pluralityof nozzle bodies such that the one or more differently sized particlesoperate to reach and treat different portions of one or more airways ofa user of the atomizer.
 2. An atomizer according to claim 1, wherein theatomization device includes a first nozzle body with at least one firstnozzle outlet and a second nozzle body with at least one second nozzleoutlet, wherein the first nozzle body is connected to the first passageand the second nozzle body is connected to the second passage.
 3. Anatomizer according to claim 2, wherein the first nozzle outlet of thefirst nozzle body and the second nozzle outlet of the second nozzle bodyare inclined relative to each other.
 4. An atomizer according to claim2, wherein, wherein the two nozzle outlets of a nozzle body are inclinedrelative to each other.
 5. An atomizer according to claim 1, wherein thefirst and second passages are guided into at least one of the pluralityof nozzle bodies of the atomization device and are each provided with afirst and a second nozzle outlet.
 6. An atomizer according to claim 1,wherein a mixing passage is arranged in front of at least one of theplurality of nozzle bodies of the atomization device, and the first andsecond passages are brought together in the mixing passage.
 7. Anatomizer according to claim 1, wherein at least one of the plurality ofnozzle bodies of the atomization device has a plenum chamber which isarranged therein and in which the first and second passages are broughttogether.
 8. An atomizer for mixing and dispensing a liquid for medicalpurposes, comprising: a cartridge holder, operable to receive at leastone cartridge therein, which is arranged in the housing, a mouthpiecewhich is provided on the housing and includes an atomization device,which is operable to dispense the liquid in a flow direction, and aconnecting tube system which connects the atomization device and thecartridge holder, wherein the atomization device has at least two nozzlebodies, each of the nozzle bodies having at least two nozzle outletsthat are sized and shaped such that each nozzle body produces one ormore particles that are different in size from the other one or moreparticles of the other nozzle bodies, the connecting tube system has atleast one passage with a hollow plunger mounted displaceably therein,and the hollow plunger comprises a first and a second plunger portionsuch that the first plunger portion is mounted displaceably in a firstpassage and the second plunger is mounted displaceably in a secondpassage of the connecting tube system, wherein the first and the secondplunger portions extend from the at least one cartridge in the flowdirection, a first liquid flows from the at least one cartridge throughthe first plunger portion in the flow direction, a second liquid flowsfrom the at least one cartridge through the second plunger portion inthe flow direction, and the nozzle outlets of each of the nozzle bodiesare spaced and inclined such that the first liquid emerging from thenozzle outlets of the first nozzle body mixes with the second liquidfrom adjacent nozzle outlets of the second nozzle body in a manner thatthe liquid is atomized to include the one or more differently sizedparticles by the plurality of nozzle bodies such that the one or moredifferently sized particles operate to reach and treat differentportions of one or more airways of a user of the atomizer.
 9. Anatomizer according to claim 8, wherein the at least two nozzle outletsof a common nozzle body are inclined relative to each other.
 10. Anatomizer according to claim 9, wherein the inclined nozzle outlets areoriented in such a way that they produce jet directions of the liquidsat an impingement angle selected from the group consisting of: 20° to160°, 60° to 150°, and 80° to 100°.
 11. An atomizer according to claim10, wherein the nozzle outlets arranged on a nozzle body are arranged ata distance selected from the group consisting of: 10 μm to 200 μm, 10 μmto 100 μm, 30 μm to 70 μm, and at 50 μm.
 12. An atomizer according toclaim 1, wherein a valve body is arranged at the end of the hollowplunger, which is the downstream end in the flow direction.
 13. Anatomizer according to claim 1, wherein the at least one nozzle body isfixed stationarily to the at least one passage.
 14. An atomizeraccording to claim 1, wherein the cartridge holder is mounted movably.15. An atomizer according to claim 1, wherein a stressing element isarranged in the housing to store a predetermined amount of energy. 16.An atomizer according to claim 15, wherein upon actuation of a releasebutton the stressing element provides the amount of energy and displacesthe cartridge holder in the axial direction of the housing.
 17. Anatomizer according to claim 15, wherein the stressing element displacesthe cartridge in the direction of the atomization device.
 18. A systemcomprising an atomizer for mixing and dispensing a liquid for medicalpurposes, comprising: a cartridge holder, operable to receive at leastone cartridge therein, which is arranged in the housing, a mouthpiecewhich is provided on the housing and includes an atomization device,which is operable to dispense the liquid in a flow direction, and aconnecting tube system which connects the atomization device and thecartridge holder, wherein the atomization device has a plurality ofnozzle bodies, each of the nozzle bodies having at least two nozzleoutlets that are sized and shaped such that each nozzle body producesone or more particles that are different in size from the other one ormore particles of the other nozzle bodies, and the connecting tubesystem has at least one passage with a hollow plunger mounteddisplaceably therein, wherein a first liquid is stored in a firstcartridge or cartridge chamber and a second liquid is stored in a secondcartridge or cartridge chamber which is spatially separated from thefirst cartridge or cartridge chamber, and wherein the nozzle outlets ofeach of the nozzle bodies are spaced and inclined such that the firstliquid emerging from the first and second nozzle outlets of the firstnozzle body mixes with the second liquid from the first and secondnozzle outlets of the second nozzle body in the flow direction toproduce the liquid, and the liquid is atomized into the one or moredifferently sized particles by the plurality of nozzle bodies such thatthe one or more differently sized particles operate to reach and treatdifferent portions of one or more airways of a user of the atomizer. 19.An atomizer according to claim 15, wherein the branched end of thehollow plunger is located between the stressing element and the passageof the connection tube system.